Violence against women has reached epidemic proportions. It is estimated that 1 in 6 women will be raped during her lifetime. Women who have been sexually assaulted have identified feelings of guilt and humiliation, a fear of retribution by the perpetrator, and a general lack of knowledge and trust of the medical and legal system as reasons for not reporting or delaying reporting the assault to the police. One strategy that has the potential to increase women's trust after sexual assault is a standardized, competent, and compassionate exam completed by specially trained health care professionals (for example, Sexual Assault Nurse Examiners (SANE) or physicians). These health care professionals provide immediate medical care, evidence collection, and eventual expert witness in later trials. Although this role has been in existence for approximately twenty years, genital injury data have not been studied scientifically nor viewed collectively to identify the patterned injuries after a sexual assault. Research is critically needed to discriminate between injuries that occur with consensual as compared to nonconsensual intercourse. In addition, it is essential to establish criteria and guidelines based on scientific data to devise standardized clinical assessment instruments for the evidentiary findings of adult sexual assault victims. As a result of this gap, admission of evidence by specially trained forensic nurse examiners has recently been challenged in the courts. Because the judicial system relies on the sexual assault examination record as a critical component to determine the cause of the victim's injuries, it is imperative that the evaluation of evidentiary findings is scientifically grounded. Therefore the purpose of this study is to distinguish the constellation of history and genital patterned injuries specific to nonconsensual, or forced, sex in comparison to consensual intercourse. The specific aim of this study is to identify the injury patterns specific to women who have been sexually assaulted and compare these findings to women who have had consensual intercourse. The goals for this research are to compare injury patterns over time between women after consensual and nonconsensual intercourse.